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President Bush’s Health Nominees Choices

March 26, 2002 at 12:00 AM EDT
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PRESIDENT GEORGE W. BUSH: It is my honor to nominate two fine men to head important government institutions to take important jobs. My nominee to lead the National Institute of Health is Elias Zerhouni, and my nominee as the next Surgeon General is Richard Carmona.

Dr. Zerhouni shares my view that life is precious and should not be exploited or destroyed for the benefits of others. And he shares my view that the promise of ethically conducted medical research is limitless. As director of the NIH, Dr. Zerhouni will be at the forefront of our efforts to promote biomedical research with a careful regard for the bounds of medical ethics.

When I first learned that Dr. Richard Carmona once dangled out of a moving helicopter, I worried that maybe he wasn’t the best guy to educate our Americans about reducing health risks. But that turned out to be just one of several times that Dr. Carmona risked his own life to save others. As an Army Green Beret in Vietnam, a decorated police officer in Pima County, Arizona, a swat team member, a nurse, and a physician, Dr. Carmona has redefined the term hands-on medicine.

JIM LEHRER: More now from our health correspondent, Susan Dentzer.

Susan, let’s take these two nominees one at a time. Dr. Carmona of Tucson to be Surgeon General — the man who dangled out of an airplane. What was he doing dangling out of an airplane?

SUSAN DENTZER: This was in 1992, Jim, and he was apparently trying to rescue somebody who was stranded on a mountain. It’s just part and parcel of a long career that he’s had, which has straddled the areas of law enforcement on the one hand and also medicine. He has spent a good part of his career in emergency response and swat team. He’s actually a member of the swat team in Pima County, Arizona. And before that, of course, as the President noted today, he was a medic in Vietnam and earned the purple heart and the bronze star in that capacity.

JIM LEHRER: What do we know about his views on health policy at this point?

SUSAN DENTZER: Not a great deal. We do know that he does have long experience in the field of emergency response and bio terrorism, and in fact, as a faculty member at the University of Arizona he was instrumental in helping to draw up that university’s emergency response and bio terrorism preparedness plan. So that suggests that he’s got a keen interest in helping to shape the public health service’s ongoing ability to respond to bio terrorist and other emergency attacks.

JIM LEHRER: Does he have known positions on things like abortion, stem cell research, or are those kinds of views even relevant to this job as Surgeon General?

SUSAN DENTZER: Not strictly speaking. One suspects that if he has views on abortion, whether he’s pro choice or on the other side of the fence, he is keeping it very quiet because of course it’s understood that the President’s position is against abortion. In his position as Surgeon General, however, it’s not likely he would have to step up to the plate very often on those kinds of issues. The Surgeon General is a key person in the Administration — every Administration in isolating important public health and health issues for the American public and he shows every sign of being keenly interested in doing that as far as it regards preventive medicine, basically doing as much to help Americans get as healthy as possible to avert serious diseases.

JIM LEHRER: Is it a policy position, or is it more of a kind of broadcast position, in other words spreading the word, that comes from other elements in the health care system? How would you explain the job?

SUSAN DENTZER: It’s both. It’s both overseeing the 5,0000 commissioned officers of the public health service, they are in effect a standing army of public health officers who will respond to epidemic outbreaks in some instances – there were PHS officials on hand for the attacks of 9/11 to actually carry out some response efforts there. So it’s that — it’s a management job to that degree, but it’s also a job of basically identifying and holding up to the limelight some of the important public health problems that we face. The prior Surgeon General, David Satcher, for example, issued some very important reports in the fields of mental health, children’s mental health and so on. There’s every expectation that Dr. Carmona will do much the same thing in terms of honing in on these key issues.

JIM LEHRER: Many of course remember that it was a Surgeon General of the United States who started the whole anti-smoking thing many, many years ago with a report…

SUSAN DENTZER: Absolutely right.

JIM LEHRER: ….and a health connection.

SUSAN DENTZER: Yes, indeed, and a subsequent Surgeon General, Dr. Koop, was a signal person in identifying the AIDS threat, so Surgeon Generals have a long history of doing exactly that.

JIM LEHRER: All right. Now Dr. Zerhouni to head the NIH, the National Institutes of Health – first give us a picture of that institution.

SUSAN DENTZER: The National Institutes of Health is the premiere entity in the nation that essentially dedicates large amounts of money for biomedical research, conducts some of that in house at what’s known as intramural research, but funnels most of it out of door to universities, to medical schools, to hospital across the country to conduct both basic biomedical research and also what’s called translational research – turn that into clinical treatments, therapies for individuals. There are 27 institute and centers at the National Institute of Health. They include the National Cancer Institute, the National Heart, Blood & Lung Institute, as well as centers in complimentary and alternative medicine. The budget of the NIH has been doubled with the President’s request to fund it to the tune of $27 billion in fiscal 2003. The budget will have been doubled since fiscal 1998. So there’s a very large management challenge in terms of getting much of that money out the door into the hands of biomedical researchers.

JIM LEHRER: Now, that leads us to Dr. Zerhouni. What do we need to know about him?

SUSAN DENTZER: What we do know is that he is a very highly regarded individual coming out f Johns Hopkins University, which not – perhaps coincidentally – is the nation’s number one institutional recipient of NIH funding. It’s receiving close to $500 million a year now in NIH funds to conduct its premiere research. He is an Algerian immigrant. He obtained his medical degree in Algiera — came to the United States to continue his training, went through his residency program in radiology at Hopkins. Except for a short stint at another institution he’s been at Hopkins for most of his career. He’s risen through the ranks there to become what people now call a quadruple threat. He’s a premiere clinician, actually a person who treats patient, he’s considered a very good teacher. He’s an excellent researcher, particularly in the area of radiology. He’s made some innovations in applying magnetic resonance imaging technology to actually detect changes in the heart at the cellular level that can signal heart disease down the line. On top of that he’s said to be excellent administrator as well and that’s the job he currently holds at Hopkins as executive vise dean.

JIM LEHRER: What do we know about his views on stem cell research? You heard what the President just said – that they’re in sync on this.

SUSAN DENTZER: Right.

JIM LEHRER: What does that mean?

SUSAN DENTZER: Much of that remains to be seen. We know that Dr. Zerhouni was instrumental in creating at Hopkins the Institute for Cell Engineering, which is the home, among other things, of the stem cell research that takes place at Hopkins. He has already been attacked by some on the far right for being a proponent of stem cell research, although people close to him say that he’s quite prepared to live within the President’s guidelines, as announced last August, which, in effect, would allow embryonic stem cell research on lines of stem cells that were created before August.

JIM LEHRER: Both of these men have to go – quickly – to the United States Senate for confirmation. Any rumblings today one way or another about problems for them?

SUSAN DENTZER: Yes. There’s a great desire to press Zerhouni on exactly where he stands on stem cell research. He in particular — it is said by some that he signed a letter saying that was also supportive of the President’s position against cloning. That is troubling to some in Congress because that would include what’s called therapeutic cloning.

JIM LEHRER: All right. But as we sit here now, is there any major thing already brewing that could cause either Dr. Carmona or Dr. Zerhouni to have a problem, or do you know?

SUSAN DENTZER: I doubt it. In fact, the Congress has signaled that it intends to move quickly appointing them. I think there will be intensive grilling because most of the people who are keenly interested in NIH funding are also keenly interested in what funding is going to be coming forth in this whole area of therapeutic cloning and stem cell research. That’s why he’s going to be grilled very closely on where he stands, but in the end I suspect he will be confirmed.

JIM LEHRER: Thank you very much.

SUSAN DENTZER: Thanks, Jim.